ObjectivesTo determine if subpopulations of students benefit equally from school-based physical activity interventions in terms of cardiorespiratory fitness and physical activity. To examine if ...physical activity intensity mediates improvements in cardiorespiratory fitness.DesignPooled analysis of individual participant data from controlled trials that assessed the impact of school-based physical activity interventions on cardiorespiratory fitness and device-measured physical activity.ParticipantsData for 6621 children and adolescents aged 4–18 years from 20 trials were included.Main outcome measuresPeak oxygen consumption (VO2Peak mL/kg/min) and minutes of moderate and vigorous physical activity.ResultsInterventions modestly improved students’ cardiorespiratory fitness by 0.47 mL/kg/min (95% CI 0.33 to 0.61), but the effects were not distributed equally across subpopulations. Girls and older students benefited less than boys and younger students, respectively. Students with lower levels of initial fitness, and those with higher levels of baseline physical activity benefitted more than those who were initially fitter and less active, respectively. Interventions had a modest positive effect on physical activity with approximately one additional minute per day of both moderate and vigorous physical activity. Changes in vigorous, but not moderate intensity, physical activity explained a small amount (~5%) of the intervention effect on cardiorespiratory fitness.ConclusionsFuture interventions should include targeted strategies to address the needs of girls and older students. Interventions may also be improved by promoting more vigorous intensity physical activity. Interventions could mitigate declining youth cardiorespiratory fitness, increase physical activity and promote cardiovascular health if they can be delivered equitably and their effects sustained at the population level.
Summary
Objective To analyze the effect in obese pre‐ and postmenopausal women of a daily dose of 100 mg dehydroepiandrosterone‐sulphate (DHEA‐S) provided over a period of 3 months as replacement ...therapy against metabolic syndrome.
Context Although DHEA‐S appears to be effective against certain features of metabolic syndrome, its usefulness against this syndrome as a whole has not been evaluated to date.
Design/Patients A randomized, double‐blind placebo‐controlled trial was conducted involving 61 postmenopausal women, who received DHEA‐S (n = 41) or placebo (n = 20) for 3 months. The effect of DHEA‐S treatment on the same postmenopausal women was compared with the effects observed in a group of premenopausal women (n = 20).
Measurements Anthropometric measurements were taken at the beginning and at the end of the treatment. Similarly, different parameters that define metabolic syndrome and other cardiometabolic variables were determined.
Results Dehydroepiandrosterone‐sulphate replacement produced weight loss in the obese women studied. Moreover, waist circumference, glucose and systolic and diastolic blood pressure, among other metabolic syndrome parameters, improved in the postmenopausal group, who showed a significant reduction in the total metabolic syndrome score (P < 0·05). In contrast, in premenopausal women, the effect of DHEA‐S was limited to obesity parameters, and no effect was observed on metabolic syndrome components. No significant changes were evident in the placebo group.
Conclusions An oral dose of DHEA‐S is useful for weight loss. In obese postmenopausal women, the hormone significantly improves plasma biochemical levels and anthropometric characteristics, leading to a better metabolic profile, which highlights the usefulness of this therapy against metabolic syndrome in this group of women.
The treatment of type-1 diabetes mellitus (T1DM) requires changes in patients’ eating habits and lifestyles which could lead to the development of an eating disorder (ED). An early detection of these ...disorders in subjects with T1DM is necessary. However, there is no specific questionnaire concerning the presence of an ED in these patients.
To translate and validate for the Spanish population a specific questionnaire aimed at detecting the risk of onset of an ED on a sample of subjects with T1DM. To analyze its agreement with its shortened version and with the gold standard tool, EAT-26.
Cross-sectional study. The study population consisted of 112 adults with T1DM. The EAT-26 tool and DEPS-R questionnaire were used to detect subjects at risk for developing ED. In addition, several characteristics such as weight, height, BMI, age and age of onset were assessed by means of self-administered questionnaires, in order to study their correlation with test scoring.
Structural properties of the tests were evaluated through methodological procedures aimed at calculating reliability and validity. The translated and adapted version had a high consistency in both its complete and summarized version (α=0.821). The test-retest also yielded consistent results (intraclass correlation coefficient 95.8% for EPAD and 92.3% for EPAD-R). The factor analysis yielded 5 factors: (1) Eating attitudes; (2) Bulimic behaviour; (3) Weight control; (4) Avoidance, and (5) Restriction.
We have developed a questionnaire in Spanish capable of identifying the risk of onset of a specific ED in patients with T1DM. The EPAD-R questionnaire detected 10% more cases and different ones than those detected by the EAT-26 test. It is necessary to use specific screening tools to correctly identify eating disorders in patients with T1DM.
El tratamiento de la diabetes mellitus tipo 1 (DMT1) exige modificaciones de los hábitos alimentarios y estilos de vida que pueden conducir a desarrollar trastornos de la conducta alimentaria (TCA). Es necesaria la detección precoz de estos trastornos en sujetos con DMT1. Sin embargo, no existe un cuestionario específico sobre la presencia de TCA en este tipo de pacientes.
Traducir y validar al español un cuestionario específico para detectar el riesgo de TCA en sujetos con DMT1. Analizar su concordancia con una versión resumida y con la herramienta de referencia EAT-26.
Estudio transversal. La muestra estuvo compuesta por 112 adultos con DMT1. Para la detección del riesgo de TCA se utilizaron los cuestionarios EAT-26 y DEPS-R. Características como el peso, la talla, el IMC, la edad y la edad de inicio fueron evaluadas.
Se evaluaron las propiedades estructurales de la prueba a través de procedimientos metodológicos para calcular la fiabilidad y la validez. La versión traducida y adaptada demostró una consistencia muy elevada entre la versión completa y la resumida (α=0,821). La prueba test-retest también resultó consistente (coeficiente de correlación intraclase de 95,8% para EPAD y de 92,3% para EPAD-R). El análisis factorial resultó dar 5 factores: 1) Actitudes alimentarias; 2) Conductas bulímicas; 3) Control de peso; 4) Evitación, y 5) Restricción.
Hemos desarrollado un cuestionario en español capaz de identificar el riesgo de TCA específico para sujetos con DMT1. El cuestionario EPAD-R detectó un 10% más de casos y estos fueron diferentes a los detectados por el EAT-26. Para identificar correctamente los TCA en diabéticos es necesario utilizar herramientas de cribado específicas.
Abstract Objective Obesity itself could be a key factor determining fatty acid (FA) composition of adipose tissue (AT). A Mediterranean diet influences this relationship. However, a relation between ...different overweight and obesity levels (including morbidly obese subjects) and AT FA pattern has not been fully established. The objective of the present study was to analyze potential differences in AT FA composition attending to degree of obesity in patients who follow a Mediterranean dietary pattern. Methods Our study comprises 60 patients classified as overweight, obese, or morbidly obese (20 subjects in each group). Dietary composition was assessed by a 7-d record, and visceral and subcutaneous AT FAs were analyzed by gas chromatography. Cardiometabolic risk-related parameters were also assessed. Results Our results showed that dietary habits were similar among groups, although palmitic intake was higher and palmitoleic intake was lower in the morbidly obese group. Concerning AT, we observed significant differences in the visceral depot. Concretely, both total monounsaturated FA ( P = 0.039) and palmitoleic acid ( P = 0.008) were higher in overweight subjects. Most differences were found in the subcutaneous tissue. Among them, n -9 and total monounsaturated FA ( P < 0.001) were significantly higher again in overweight subjects, while 22:6 n -3 was higher in morbidly obese subjects. Subcutaneous adipose dihommo-γ-linolenic content and dietary palmitic and palmitoleic acids were independent predictors of body mass index. Conclusions We confirm the relationship between degree of obesity and dietary and AT FA composition in this Mediterranean population. Despite a similar dietary pattern among groups, overweight and morbidly obese patients have a less detrimental FA profile than obese patients, probably due to differences in adipose tissue metabolism.
Simulation has traditionally been used to train health care professionals, being focused on the human development side and less on the organizational or systemic level. More recently, simulation has ...been effectively used to enhance the potential of different quality and management models and tools. However, with very few exceptions, those models and tools have not been equally applied to maximize the full potential of simulation.
This quality improvement project describes the process improvement methodology based on Lean principles and tools used to obtain standard ISO 9001:2015 certification of an Advanced Simulation Centre (ASC). In addition, it proposes an easy to generalize visual approach, to using quality tools for the design of a client centered quality management system.
The ASC was certified to the requirements demanded by the international ISO 9001:2015 standard. The designed processes based on customers' expectations, risk thinking, and Lean principles, were included in a Processes Manual that gained intellectual property rights.
This article was written on the assumption that our experience might prompt other simulation centers to deploy quality management models that would help them broaden their scope of activity and achieve their maximum development.
•Increasing simulation full potential through the use of management models and tools.•Widening simulation centers' scope through strategic planning.•Implementing a quality management system in an advanced simulation center.•Processes improvement based on ISO 9001:2015 standard and Lean principles and tools.
The present paper updates the Clinical Practice Recommendations for the management of cardiovascular risk factors (CVRF) in diabetes mellitus. This is a medical consensus agreed by an independent ...panel of experts from the Spanish Society of Diabetes (SED). Several consensuses have been proposed by scientific and medical Societies to achieve clinical goals. However, the risk score for general population may lack sensitivity for individual assessment or for particular groups at risk, such as diabetics. Traditional risk factors together with non-traditional factors are reviewed throughout this paper. Intervention strategies for managing CVRF in the diabetic patient are reviewed in detail: balanced food intake, weight reduction, physical exercise, smoking cessation, reduction in HbA1c, therapy for high blood pressure, obesity, lipid disorders, and platelet anti-aggregation. It is hoped that these guidelines can help clinicians in the decisions of their clinical activity. This regular update by the SED Cardiovascular Disease Group of the most relevant concepts, and of greater practical and realistic clinical interest, is presented in order to reduce CVR of diabetics.
Seeking solutions to obesity Tébar Massó, Francisco Javier
Public health nutrition,
10/2007, Letnik:
10, Številka:
10A
Journal Article
Recenzirano
Odprti dostop
The Congress included four interesting contributions regarding adipose tissue response with respect to lipogenesis and lipolysis: modifications in the composition of adipose tissue as a function of ...the quantity and type of fatty acids in the diet; the role of PPAR-γ and PGC-1 in adipogenesis and lipotoxicity phenomena and the relation between natriuretic peptides and lipolysis; and, lastly, the mechanism by which the UCP and brown adipose tissue are involved in lipolysis.
The COVID-19 pandemic led to the cancellation of non-essential surgical procedures in March 2020. With the resumption of surgical activity, patients undergoing surgery were one of the first ...population groups to be systematically tested for PCR. The aim of this study was to determine the prevalence of asymptomatic SARS-CoV-2 carriers after the resumption of non-essential surgical activity.
Retrospective multicenter observational study of patients scheduled for surgery or undergoing emergency surgery in Catalonia between 20 April and 31 May 2020. The microbiological results of preoperative PCR tests and clinical records were reviewed, and an epidemiological survey was conducted on patients with positive PCR for SARS-CoV-2.
A total of 10,838 patients scheduled for surgery or who underwent emergency surgery were screened for COVID-19. One hundred and eighteen patients (1.09%) were positive for SARS-CoV-2 in the 72hours prior to surgery. The prevalence of asymptomatic carriers was 0.7% (95%CI: 0.6% - 0.9%). The first week of the study presented the highest prevalence of asymptomatic carriers 1.9% (95%CI: 1.1%-3.2%).
The low levels of asymptomatic carriers of COVID-19 infection obtained in the surgical population of hospitals in Catalonia after the resumption of surgical activity, shows that most patients were able to undergo surgical procedures without the risks of COVID-19 associated complications in the perioperative period.
Resumen El presente documento actualiza las recomendaciones de práctica clínica del manejo de los factores de riesgo cardiovascular (FRCV) en la diabetes mellitus (DM). Es un consenso médico ...realizado por un panel de expertos independiente de la Sociedad Española de Diabetes (SED). Se han propuesto y actualizado varios consensos de diferentes sociedades científicas o médicas con el fin de mejorar los resultados terapéuticos. La valoración del RCV en la población general puede carecer de sensibilidad para la evaluación individual en determinados grupos de riesgo como los diabéticos. Se revisan los factores de riesgo tradicionales y no tradicionales, así como las estrategias de intervención para el control de los FRCV en los pacientes diabéticos como la dieta, el control ponderal, el ejercicio físico, los hábitos tóxicos, el control glucémico, tensional y lipídico, así como la antiagregación plaquetaria. Confiamos en que estas pautas ayuden a los médicos en la toma de decisiones en su actividad asistencial. Se expone una actualización de los conceptos más relevantes y de mayor interés clínico-práctico y, a su vez realista, para reducir el RCV de los diabéticos como se venía haciendo regularmente por parte del Grupo de Enfermedad Cardiovascular de la SED.
PDF
